Bacteriuria Following Extracorporeal Shock Wave Lithotripsy of Infection Stones

Abstract

No AccessJournal of Urology1 Aug 1988Bacteriuria Following Extracorporeal Shock Wave Lithotripsy of Infection Stones Eli K. Michaels, Jackson E. Fowler, and Michele Mariano Eli K. MichaelsEli K. Michaels More articles by this author , Jackson E. FowlerJackson E. Fowler More articles by this author , and Michele MarianoMichele Mariano More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)41576-XAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Extracorporeal shock wave lithotripsy effectively pulverizes infected (struvite) renal calculi. However, after treatment minute residual fragments that may harbor bacteria and cause persistent bacteriuria remain in the renal collecting system for months. We investigated prospectively the incidence of persistent Proteus mirabilis bacteriuria after extracorporeal shock wave lithotripsy among 15 consecutive women with Proteus mirabilis urinary tract infections and struvite calculi. All patients received parenteral gentamicin for 3 to 8 days (mean 4.7 days) immediately before and after extracorporeal shock wave lithotripsy. Oral antimicrobials then were administered for 14 to 34 days (mean 25 days). Ten patients have maintained a sterile urine or experienced urinary reinfection by other organisms during 8 to 19 months (mean 13 months) of subsequent bacteriological surveillance. Of these 10 patients 9 had residual fragments. Five patients had Proteus mirabilis bacteriuria after 1 to 7 months of surveillance, including 3 with residual fragments. The mean stone size, methods and duration of renal drainage procedures, and duration of antimicrobial therapy were similar for the 2 patient groups. Proteus mirabilis was isolated from the cultures of only 3 of 11 retrievable stone fragments. In contrast to intact infected renal calculi, residual stone fragments after extracorporeal shock wave lithotripsy often are susceptible to sterilization with antimicrobials. © 1988 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byAssimos D (2018) Re: A Multi-Institutional Study of Struvite Stones: Patterns of Infection and ColonizationJournal of Urology, VOL. 198, NO. 4, (737-737), Online publication date: 1-Oct-2017.Cohen T, Streem S and Lammert G (2018) Long-Term Incidence and Risks for Recurrent Stones Following Contemporary Management of Upper Tract Calculi in Patients with a Urinary DiversionJournal of Urology, VOL. 155, NO. 1, (62-65), Online publication date: 1-Jan-1996.Streem S (2018) Long-Term Incidence and Risk Factors for Recurrent Stones Following Percutaneous Nephrostolithotomy or Percutaneous Nephrostolithotomy/Extracorporeal Shock Wave Lithotripsy for Infection Related CalculiJournal of Urology, VOL. 153, NO. 3, (584-587), Online publication date: 1-Mar-1995.Cohen T, Streem S and Lammert G (2018) Selective Minimally Invasive Management of Calculi in Patients with Urinary DiversionsJournal of Urology, VOL. 152, NO. 4, (1091-1094), Online publication date: 1-Oct-1994.Cicerello E, Merlo F, Gambaro G, Maccatrozzo L, Fandella A, Baggio B and Anselmo G (2018) Effect of Alkaline Citrate Therapy on Clearance of Residual Renal Stone Fragments after Extracorporeal Shock Wave Lithotripsy in Sterile Calcium and Infection Nephrolithiasis PatientsJournal of Urology, VOL. 151, NO. 1, (5-9), Online publication date: 1-Jan-1994.Krings F, Tuerk C, Steinkogler I and Marberger M (2018) Extracorporeal Shock Wave Lithotripsy Retreatment (“Stir-Up”) Promotes Discharge of Persistent Caliceal Stone Fragments after Primary Extracorporeal Shock Wave LithotripsyJournal of Urology, VOL. 148, NO. 3 Part 2, (1040-1041), Online publication date: 1-Sep-1992.Streem S and Lammert G (2018) Long-Term Efficacy of Combination Therapy for Struvite Staghorn CalculiJournal of Urology, VOL. 147, NO. 3 Part 1, (563-566), Online publication date: 1-Mar-1992.Lam H, Lingeman J, Barron M, Newman D, Mosbaugh P, Steele R, Knapp P, Scott J, Nyhuis A and Woods J (2018) Staghorn Calculi: Analysis of Treatment Results between Initial Percutaneous Nephrostolithotomy and Extracorporeal Shock Wave Lithotripsy Monotherapy with Reference to Surface AreaJournal of Urology, VOL. 147, NO. 5, (1219-1225), Online publication date: 1-May-1992.Michaels E and Fowler J (2018) Extracorporeal Shock Wave Lithotripsy for Struvite Renal Calculi: Prospective Study with Extended FollowupJournal of Urology, VOL. 146, NO. 3, (728-732), Online publication date: 1-Sep-1991.Assimos D, Wrenn J, Harrison L, McCullough D, Boyce W, Taylor C, Zagoria R and Dyer R (2018) A Comparison of Anatrophic Nephrolithotomy and Percutaneous Nephrolithotomy with and without Extracorporeal Shock Wave Lithotripsy for Management of Patients with Staghorn CalculiJournal of Urology, VOL. 145, NO. 4, (710-714), Online publication date: 1-Apr-1991.Fowler J (2018) Editorial CommentsJournal of Urology, VOL. 145, NO. 1, (9-10), Online publication date: 1-Jan-1991.Stoller M and Workman S (2018) The Effect of Extracorporeal Shock Wave Lithotripsy on the Microbiological Flora of Urinary CalculiJournal of Urology, VOL. 144, NO. 3, (619-621), Online publication date: 1-Sep-1990. Volume 140Issue 2August 1988Page: 254-256 Advertisement Copyright & Permissions© 1988 by The American Urological Association Education and Research, Inc.MetricsAuthor Information Eli K. Michaels More articles by this author Jackson E. Fowler More articles by this author Michele Mariano More articles by this author Expand All Advertisement PDF downloadLoading ...